| NPI | 1619956927 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: CA 20A9093) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: CA 20A9093) |
| 207RH0002X Internal Medicine, Hospice and Palliative Medicine (Licence: CA 20A9093) | |
| Enumeration Date | 2006-01-13 |
| Last Update Date | 2023-09-01 |